By Tamzin A. Rosenwasser, M.D.,
I remember coming into the Intensive Care Unit for a day (that is, about 30 hours) on call during my residency. The first thing I saw was the red Crash Cart in front of one cubicle. The attending physician, a gifted, hard-working, pulmonologist of sterling character, came in to do a bronchoscopy with me, to try to figure out why the patient had suddenly gotten so much worse. We found a pea lodged in the right upper mainstem bronchus, and after agonizingly ineffective attempts to remove it, the pulmonologist exclaimed, under his breath, “I wish I were a yard man!” We finally got the pea out, and the patient improved.
I wonder what that physician thinks about medicine today. The job of saving patients from things like a pea in the airway is hard, but we can often find the problem, and fixing it is very worthwhile. American medicine today is full of obstructions much worse than peas, and seemingly impossible to remove.
For example, there’s HIPAA (the Health Insurance Portability and Accountability Act). It’s a money hole—for no actual benefit. It actually tells people who CAN see their supposedly private medical information, without their knowledge, let alone their consent.
There are huge fines if someone sees something that is supposedly private in a physician’s office, but of course, no punishment or correction for the government that leaked private personal information about thousands of physicians working in the Veteran’s Administration system. The victims got nothing but a bland offer of a year’s worth of identity theft monitoring.
Then we have CLIA (the Clinical Laboratory Improvement Act), and MOC (maintenance of certification) that patients don’t hear about. They’re for doctors: meaningless, time-eating, mind-numbing busywork that distracts us from our patients, and thousands of dollars in additional costs.
Then there’s constant CME (continuing medical education). One of the CME courses on AIDS I was required to take to renew my license was so out of date it did not mention the latest drugs. It was useless to me. The whole thing is like the Potemkin villages that were created in Russia to make things look good. They were just a façade too.
Politicians never take any CFE (continuing freedom education). For a lot of them, it would have to be a remedial course, or even an introductory one, but I think that if physicians, who are extensively vetted to get licenses to practice medicine, must take CME courses, it only makes sense for legislators and the President to take courses in the meaning of freedom—in the Rule of Law, our Constitution, and how freedom to be and to do, without government shackles at every step, vaulted this nation from humble beginnings into the most inventive and productive nation ever, to the benefit of the entire world.
Now there’s also “healthcare reform.” That includes the push for the EHR (electronic health record). Physicians are being bribed with $44,000 for installing one that meets the government’s desire to have your formerly private medical record on a government database. With this system, a keystroke can fill your medical record with mistakes, yet a physician can’t write a progress note without learning to navigate a computer program so obsessive that the detail required to order a simple test would do for a moon landing. The former head of CMS (Centers for Medicare and Medicaid Services), Nancy-Ann Min DeParle, made around $2 million dollars working for the company whose program it is, before she became an unaccountable “Czar” in the present regime.
Although we know they will never work, some physicians are gamely looking into forming ObamaCare ACOs—those are “accountable care organizations.” The ACO will be accountable to the government, but not to you, the patient. Your physician will be accountable to the government for how much money it may take to treat your illness.
Besides expense and hassles, there’s the risk of prison: for example, from the DEA (Drug Enforcement Administration). If a doctor prescribes a drug for pain, and a patient sells it, it’s the doctor who is likely to go to prison. It’s a lot easier to find and accuse a physician than to deal with some of the tough drug sellers on the street. I know that because I dealt with a lot of those in the ER. You can’t see or measure pain. When a patient says he fell off a ladder and now has excruciating back pain, is the doctor supposed to say “I don’t believe it”? But treating pain can be like playing Russian Roulette with your life every day. We’re damned if we do, damned if we don’t.
Investors Business Daily reportedly published a poll that 45% or so of physicians are thinking of getting out of medical practice.
Maybe I could become a yard man. I wouldn’t need a license, would I? No Continuing Grass Education…yet? No Lawn Enforcement Administration? No Mechanical Mowing Improvement Act? No Maintenance of Flower Certification? No Electronic Shrub Record? No Plant Services Secretary telling me where to mow 3 inches high, and where to mow 4 inches instead? Just me and the plants.
After 20 years of government-imposed stress and worry— why didn’t I think of this sooner? Yes, I had my mind on that young mother with melanoma. I wanted to take care of the dear veterans who had been through so much. Tears are trickling down my cheeks.…
Dr. Tamzin Rosenwasser earned her MD from Washington University in St Louis. She is board-certified in Internal Medicine and Dermatology and has practiced Emergency Medicine and Dermatology. Dr. Rosenwasser served as President of the Association of American Physicians and Surgeons (AAPS) in 2007-2008 and is currently on the Board of Directors. She also serves as the chair of the Research Advisory Committee of the Newfoundland Club of America. As a life-long dog lover and trainer, she realizes that her dogs have better access to medical care and more medical privacy than she has, and her veterinarians are paid more than physicians in the United States for exactly the same types of surgery.